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Axial Master Stack
Axial Master Stack (except skull)
| Question | Answer |
|---|---|
| What is the SID for the AP axial projection of the C spine? | 40 inches |
| What is the SID for the AP oblique projection of the C spine? | 72 inches |
| What is the SID for the lateral projection of the C spine? | 72inches |
| Another name for C1? | Atlas |
| Another name for C2? | Axis |
| What is the name of the bony prominence on C2 that articulates with the anterior arch of C1? | Dens |
| What artery runs though the transverse foramen of the C spine? | Vertebral artery |
| What is the CR angle for the AP axial of the Cspine? | 15-20 cephalic |
| What is the centering point for the AP oblique projection of the Cspine? | C4 |
| What is the CR angle for the PA oblique projection of the Cspine? | 15-20 Caudal |
| What projection would demonstrate the apophyseal joints of the Cspine? | Lateral |
| What position would demonstrate the right intervertebral foramen of the Cspine? | LPO or RAO |
| What makes up the intervertebral foramen of the Cspine? | the inferior and superior vertebral notches |
| What makes up the spinous processes of the Cspine? | The fusion of the Lamina |
| What is the centering point for the AP axial projection of the Cspine? | C4 |
| Describe how to position the head for the Odontoid position? | Align the inferior surface of the upper incisors with the base of the Occipital bone so that they are perpendicular to the IR, then drop the jaw of the patient while keeping head still. |
| If you want to visualize the Intervertebral Formina of the C spine, what degree of rotation is needed? | 45 degree oblique (upside, posterior oblique) |
| If you want to visualize the Zygapophyseal joints of the C spine, what degree of rotation is needed? | A lateral projection. 90 Degrees. |
| What anatomical landmark is at the level of C3 | Gonion or angle of the jaw |
| What anatomical landmark is at the level of C5 | thyroid cartilage or Adams apple |
| What is the kV for cervical exams | 70-80kV |
| All cervical images are taken on an 8X10LW except | swimmers projection is taken 10X12LW |
| What are other names for the swimmers projection of the C spine | cervicothoracic or Twining method |
| For a lateral and swimmers projection of the C spine breathing should be on inspiration or expiration to drop the shoulders | suspended full expiration |
| For the odontoid, AP axial and obliques of the C spine breathing should be on inspiration or expiration | suspend respiration ( stop breathing) |
| Why don’t you move a trauma C spine patient in a neck collar, some pathology | fractures, sublaxation, or cervical instability |
| What does the Fuch (AP) or Judd (PA) methods for the C spine visualize | C1 to C2 (Dens) |
| How much is the patient rotated for a Cervical oblique projection to see the intervertebral formina | 45deg oblique |
| Is the tube angled 15deg cephalic or caudad for LPO and RPO projections of the Cspine? Will upside or downside be visualized? | CR 15 deg cephalic PO’s visualize upsides |
| What projection of the C spine visualizes the zygapophyseal joints | 90deg lateral projection |
| Does C1 the atlas have a vertebral body | no, an anterior arch |
| This Cervical vertebrae contains the Dens | C2 the axis |
| What vertebrae have short spinous processes with bifid tips | C2 to C6 |
| How many foramina do each cervical vertebrae have | 3 each |
| What is C7 also known as | vertebra prominens because of its long spinous process |
| What are Cervical examinations usually done erect vs. recumbrent like a T spine | demonstrate alignment and ligament stability , allows natural curvature of spine to be demonstrated |
| What is a Jefferson fracture | anterior and posterior arches of C1 are fractured as the skull slams into the ring |
| What are the basic projections for a cervical spine exam | AP open mouth, AP axial, obliques, lateral, swimmers |
| What vertebrae is 1in below the external acoustic meatus or EAM | C1 which is the level of the mastoid tip |
| An open atlantoaxial joint can be visualized with what projection of the C spine | AP open mouth projection |
| What can you do if C7 was not demonstrated on lateral C spine image | take image on expiration, have patient hold weights, take a swimmers |
| What cervical projection aligns the midcoronal plane at a 45 deg angle with the IR and the CR has a 15deg caudad angle | posterior oblique C spine projection |
| What does a LPO and RAO of the C spine demonstrate? | the Right cervical intervertebral foramina |
| If the AP axial oblique cervical image demonstrates closed joint spaces and distorted bodies what is likely to be the fault | CR angle inaccurate |
| What is lordosis? | abnormal lumbar curvature with increased concavity aka swayback |
| what is kyphosis? | abnormal thoracic curvature with increased convexity aka humpback |
| what is scoliosis? | abnormal lateral curvature |
| what is unique about the C-spine spinous processes? | they are bifid |
| What is the SID for the AP axial projection for cspine | 40in |
| What is the SID for the AP oblique projection for cspine | 72in. |
| What is the other name for C1_______ C2______? | Atlas, C2 Axis |
| What is the name of the bony prominence on C2 that articulates with the anterior arch of C1 | dens or odontoid process |
| What artery runs through the transverse foramen for cspine | vertebral artery |
| What is the CR angle for the AP axial of the C-spine | 15-20 degrees cephalad centered to C4 |
| What is the centering point for the PA oblique projection of the C-spine | 15 degrees caudad centered to C4 |
| What is the SID for a lateral C-spine | 72in. |
| What projection would demonstrate the apopyseal joints of the cervical spine | lateral C spine |
| What position would demonstrate the right intervertebral foramen of the cervical spine | RAO and LPO |
| What makes up the intervertebral foramen of the cervical spine_____ and _____ ? | inferior and superior vertebral notch |
| What makes up the spinous process of the cervical spine | fusing of the lamina |
| What is the centering point for the AP axial projection for cspine | C4 |
| Describe how to position a patient for the odontoid position | adjust head so mouth is open, form a line from lower margin of upper incisors to base of skull (mastoid tips) is perpendicular to the IR |
| What is the SID for an AP of the T spine? | 40 inches |
| What is the SID for a Lateral of the T spine? | 40 inches |
| What is the SID for the Swimmers of the T spine? | 72 inches |
| What is the Centering point for the AP or Lateral Tspine? | T7 (midway between the jugular notch and the zyphoid process.) |
| If you want to visualize the Intervertebral Formina of the T spine, what degree of rotation is needed? | Lateral projection. 90 degrees. |
| If you want to visualize the Zygapophyseal joints of the T spine, what degree of rotation is needed? | 70 degree oblique. |
| What is another name for the Sternal angle? | Angle of Ludwig or Angle of Lewis |
| What is the Sternal angle? | where the Manubrium and the Sternal body meet. |
| the demifacets and full facets accept what part of the body and make up what joint for the T-spine | head of a rib to form the costovertebral joint |
| what is the kV for a T-spine exam | 80-90kV |
| what T vertebrae do not have transverse joints | T11 and T12, they only articulate at the costovertebral joint |
| what is the landmark for the xiphoid tip | T10 |
| what are the three parts of the sternum | manbrium, body, xyphoid process |
| Is the lateral thoracic projection taken on breathing tech | most often |
| how long is a breathing tech exposure for the t-spine | 3-4sec. low mA |
| T-spines are taken in a recumbrent position unless | scoliosis PT |
| what is the centering point for the swimmers projection | T1 |
| What topographical landmark would be used to find t2-t3? | Jugular Notch |
| How many thoracic vertebra are there in a normal thoracic spine? | 12 |
| What is the centering point for the AP thoracic spine? | T7 |
| What is the SID for the lateral thoracic spine? | 40 inches |
| What projection would demonstrate the left apophyseal joints of the thoracic spine? (include degree of rotation if any) | RPO 70degrees of obliquity |
| What projection would demonstrate the intervertebral foramen of the thoracic spine? (include degree of rotation if any) | Lateral 90 degree of rotation |
| What is the name of the hole in the center of a thoracic vertebra that the spinal cord passes through? | vertebral foramen |
| What is the name of the joint formed by the transverse process of the thoracic spine and the tubercle of the rib? | Costotransverse joint |
| What is the centering point for the Swimmers projection? | T1 |
| Name the projections of a basic thoracic spine exam that should use breathing technique. | Lateral and Swimmers. |
| Which end of the x-ray tube should be projected over the upper thoracic vertebra to use the anode-heel effect appropriately? | Anode (Cathode to the thicker side). |
| what kind of joints are costovertebral joints? | synovial joints, diarthrodial, and gliding movements |
| what is the position to show the posterior obliques upside for apophyseal joints of t-spine 70 degree oblique? | LPO=right side RPO=left side |
| what is the position to show anterior obliques for downside for apophyseal joints of t-spine? | LAO=left side RAO=rightside |
| What is the name for where the spinal cord tapers to a point at the lower border of L1? | Conus Medullaris |
| At the conus medullaris the spinal nerves separate into the ____________. | Cauda Equina |
| What is the most common site for lumbar puncture? | L3-L4 disk space |
| The thinnest part of the lamina is also called? | Pars interarticularis |
| Define Spondylolisthesis. | Misalignment of the vertebrae |
| What position is used to demonstrate the intervertebral foramina of the L spine? | Lateral |
| What position is used to demonstrate the Zygapophyseal joints of the L spine? | 45 degree oblique |
| An LPO of the L spine demonstrates? | the LEFT zygapophyseal joints |
| The Lower Costal Margin is at which vertebrae level? | L2-L3 |
| The ASIS is at what vertebrae level? | S1-S2 |
| What are the routine L spine projections? | AP (PA), Lateral, Lateral L5-S1 (spot), ……..obliques are rarely done anymore. |
| The Student becomes _________________ | the Master |
| what is the centering point for AP lumbar | iliac crest, L4-L5 |
| what is SID for all Lumbar and sacral images | 40in SID |
| Are the knees flexed for all Lumbar images | yes except for the upshot or AP axial L5-S1 projection when the legs are extended but have sponge for comfort |
| All lumbar images are taken on full expiration or inspiration | suspended expiration |
| name some landmarks for the Lumbar spine | symphysis ASIS iliac crest lower costal margin(L2-L3) xiphoid tip |
| what projection opens up the L4-L5 joint | the spot or lateral L5-S1 projection |
| what should be seen in a lateral projection of the Lumbar spine | T12 to distal sacrum, column aligned parallel to IR, superimposed greater sciatic notches |
| What projection should you use a lead blocker for to create an image with less scatter | Any lateral of the spine that is done on the table. |
| What apopyseal joint of the Lspine is visualized with an LAO projection | Right upside |
| what apopyseal joint of the Lspine is visualized with an RPO projection | Right down side |
| What is the ear of the Scottie dog? | The superior articular process. |
| What is the nose of the Scottie dog? | The transverse process. |
| What is the eye of the Scottie dog? | The pedicle. |
| What is the neck of the Scottie dog? | The pars interarticularis. |
| What is the body of the Scottie dog? | The lamina. |
| What is the leg of the Scottie dog? | The inferior articular process. |
| What is the joint space between the superior articular process of a lumbar vertebra and the inferior articular process of the lumbar vertebra called? | apophyseal joint |
| What topographical landmark would be used to find L4-L5 disk space? | iliac crest |
| What is the angulation for the AP axial Coccyx? | 10 degrees caudad |
| What is the angulation for the AP Sacrum? | 15 degrees cephalic |
| How many lumbar vertebra are there in a normal adult lumbar spine? | 5 |
| What is the body rotation for an oblique of the L-spine? | 45 Degrees |
| Where is the centering point for an oblique of the L-spine? | L3 or 1” superior to iliac crest, 2” medial |
| If a 14 x 17 cassette is used for an AP L-spine, where is the centering point? | L4/5 or iliac crest |
| The right apophyseal joints of the lumbar spine are demonstrated on which projection/position? | RPO |
| The intervertebral foramen of the lumbar spine are demonstrated on which projection/positions? | Lateral and Lateral L5-S1 spotl |
| Where is the centering point for the lateral L5-S1? | 1 ½ “ inferior to crest and 2” posterior to ASIS |
| What is the angulation, including direction, of the lateral L5-S1 when no sponge is used for support? | 5-8 Degrees Caudad |
| What is the amount of body rotation for the AP oblique SI joint? | 25-30 Degrees |
| What is the centering point for the AP oblique SI joint? | 1” medial to upside ASIS each lumbar spinous process is located at the level of what? |
| define pars interarticularis? | the portion of each lamina between the superior and inferior articular processes |
| what projection or position of the l-spine shows the pars interarticularis? | 45 degree obliques |
| what is the amount of rotation needed for upper lumbar region and why? | at least 50 degrees because of thoracic type characteristics |
| what is the amount of rotation needed for lower lumbar region? | about 30 degrees |
| what will show apophyseal joints for the posterior obliques downside for l-spine? | RPO= right joints LPO=left joints |
| what will show apophyseal joints for the anterior obliques upside for l-spine? | RAO=left joints LAO=right joints |
| what kind of joints are intervertebral joints? | cartilaginous, amphiarthrodial of the symphysis subclass |
| The most inferior point of the Coccyx is called the ______? | apex |
| The Coccyx was in _____ segments before fusing together? | four |
| What are the two basic view for a Scoliosis series ? | AP (PA) erect and Erect Lateral |
| What part of spine is examined in a Scoliosis series? | Thoracolumbar (all of T spine and L spine) |
| What degree of angulation is used for an AP axial of the Sacrum? | 15 degrees cephalad |
| What degree of angulation is used for an AP axial of the Coccyx? | 10 degree caudal |
| What degree of angulation is used for an AP axial of the SI joints (upshot)? | 30-35 degrees cephalad (30 for males, 35 for females) |
| What is the degree of obliquity for the Oblique of the SI joints? | 25-30 degrees |
| What is the Centering point for the Oblique of the SI joints? | 1 in medial to the upside ASIS |
| What is the Centering point for the AP axial of the Sacrum, AP axial of the Coccyx, and AP axial of the SI joints? | midsagittal plane midway between the ASIS and Pubic Symphysis |
| What is the centering point for the Lateral of the Sacrum? | 3”-4” posterior to the ASIS |
| What is the centering point for the Lateral of BOTH the Sacrum and Coccyx? | 3”-4” posterior and 1” distal to the ASIS (according to Hejny) |
| What is the centering point for the Lateral of the Coccyx? | 3”-4” posterior and 2” distal to the ASIS |
| What can you use to check for rotation in a Lateral Sacrum? | superimposition of the Sciatic Notches |
| How did you do? | Very well, grasshopper. |
| in an AP axial sacrum projection is the sacrum elongated or foreshortened | elongated |
| in an AP axial coccyx projection is the sacrum elongated or foreshortened | forshortened |
| how will a oblique projection of SI joints determine correct obliquity | ala, ilium and sacrum will demonstrate no overlap |
| SID for sacral images | 40in SID |
| for oblique SI joints what side of the patient is elevated | side of interest |
| if patient is in LPO projection for SI oblique what joint is visualized | right joint |
| Where does the fusion of the spinous processes occur? | Median Sacral Crest |
| How many sacral foramina are there? | 16(8 Anterior and 8 Posterior) |
| Why would you do a PA projection for a Scoliosis Series instead of an AP? | PA reduces patient radiation exposure |
| What is rotoscoliosis? | rolling of the spine |
| What type of joints are SI joints? | Sinovial & Plane/Gliding |
| If patient is in an LAO projection for an oblique of the SI joints, what joint is visualized? | left joint |
| What used to be used to measure the inlet and outlet of the birth canal? | promontory |
| what is the SID for scoliosis series? | 60-72 inches |
| how many sets of pelvic sacral foramina are there in the sacrum? | four sets that transmit nerves and blood vessels |
| where is the promontory located? | at the body of the first sacral segment |
| what is the median sacral crest formed by? | fused spinous processes in the sacrum |
| where does the sacrum articulate with the ilium? | at the SI joints |
| how is the sacrum shaped? | shovel shaped with apex pointed anteriorly and inferiorly |
| how is the coccyx shaped? | curves anteriroly and the apex points toward the symphysis pubis |
| What is the degree of obliquity for an oblique sternum for a thin chested thorax? | 20 degrees |
| What is the degree of obliquity for an oblique sternum for a large or barrel chested thorax? | 15 degrees |
| The oblique of the sternum is done RAO or LAO? Why? | RAO..To remove the spine from superimposition and to superimpose the heart to help visualization |
| Sternal angle is also called? | angle of lewis or Ludwig |
| True ribs | 1-7 articulate with spine and sternum |
| False ribs | 8-12 articulate with spine and sternum only indirectly thru rib 7 |
| Floating ribs | 11-12 only articulate with the spine |
| What is the Costal groove? | groove on the inferior surface of the rib for blood vessels and nerves |
| Another name for the sternal body? | corpus gladiolus |
| The jugular notch is at what vertebrae level? | t2-t3 |
| The sternal angle is at what vertebrae level? | t4-t5 |
| The xiphoid tip is at what vertebrae level? | t9 |
| The lower costal margin is at what vertebrae level? | L2-L3 |
| What is the centering point and SID for a lateral sternum? | 1.5” below jugular notch with 72” SID |
| What are the basic projections for the Sternum? | RAO and Lateral |
| What 3 parts does the sternum consist of? | Manubrium, Body, Xiphoid Process |
| How many ribs are there? | 24 (12 pairs) |
| What type of joints are costovertebral joints and costotransverse joints? | Diarthrodial & Plane/Gliding |
| Why is the RAO projection of the sternum preferred? | It gives a homogenous background |
| What is the recommended SID for an RAO of the sternum and why? | 30”, to blur the posterior ribs |
| What is it called when someone’s sternum protrudes outward? | Pigeon chested |
| Is kV low or high for the sternum? | Low (60-70kV) |
| What SID do you use for a lateral sternum? | 72” (reduces magnification) |
| Why do you place the patients arms behind their back for a lateral of the sternum? | To project the sternum forward |
| What breathing technique is done for Ribs below the diaphragm? | full expiration |
| What breathing technique is done for Ribs above the diaphragm? | full inspiration |
| What projection/position would you do if the patient had a posterior Rib injury? | AP |
| What projection/position would you do if the patient had an anterior Rib injury? | PA |
| Which Ribs should be demonstrated on an above the diaphragm image? | 1st-9th posterior ribs |
| Which Ribs should be demonstrated on a below the diaphragm image? | 8th-12th posterior ribs |
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